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intersubjective dialogue and the client’s lived experiences. Nurse and client co-create reality. Theory of Comfort Katherine Kolcaba 1991 Comfort as a holistic phenomenon. Comfort reflects holistic well-being. Comfort is described as feelings of relief, ease, and transcendence. A midrange theory applied to many practice settings. Comfort measures are assessed by the client as being in a state of comfort or having been comforted. principles of Complexity Science permits order and creativity to emerge.12 Complexity Science is undoubtedly useful to healthcare leaders and administrators and is perhaps especially helpful to holistic nurse managers who may already recognize the requirement to give over the control of actions and outcomes. Geary and Schumacher provide an example of pairing complexity theory with transition theory in the practice of discharging patients from hospital to home.13 These authors suggest that complexity theory gives nurses new tools to account for the unpredictable nature of the patient discharge situation and the multiple interacting agents that come into play simultaneously. Kramer and colleagues illustrated how newly licensed registered nurses enter practice thinking that that their actions result in more predictable outcomes than is realistic.14 These authors report that expanding nurses’ thinking to encompass complexity provides room for innovation and creates a more supportive environment in which to work. The essence of applying Complexity Science is the ability to trust the process and the people to make the right choices and decisions and to be accountable for their actions. (continued) Interdisciplinary Theories of Interest to Nursing 117 9781284082463_CH05_PASS02.indd 117 25/02/15 6:08 pm James speaks to all holistic nurses when she suggests that nurses can and should lead healthcare systems at the system level and become “healers of a very fragmented and siloed health care system.”15, p. 137 She goes on to advise that “A machine can be fixed with a replacement part, while an organic system must be cared for as a whole.”15, p. 139 Complexity Science draws nurses to a systems level and a leadership role within the healthcare system. This may well be a first step in nurses’ ability to influence the establishment of theoretic perspectives focusing on individual patient care as well. Integral Theory draws on ideas, concepts, and theories from many traditions to integrate views that interpret world and life experiences from seemingly irreconcilable differences.16 Essentially, this theory divides “all that is” into four quadrants—the four corners of the universe—each quadrant representing a domain, a view of reality, or a dimension of “what is.” The quadrants are the interior dimensions of individuals (feelings, meanings, beliefs), the interior dimensions of the collective (cultural beliefs, shared worldviews), the exteriors of individuals (the body, its organs and tissues, behaviors), and the exteriors of the collective (social structures). Wilber embraces the notion that the domains of each quadrant represent four true realities, each that can be understood through differing methods of study, sources of data, and worldviews. Thus, to understand human experience, one must understand all four dimensions. His theory can be easily applied to holistic health because it addresses the need for a comprehensive approach to treating illness and providing care to people.16 Integral approaches treat the illness, the person, and the healthcare provider— going beyond the mind–body perspective and taking a panoramic look at all modes of inquiry. This theory can be considered a metatheory (and is so considered by Wilber and his followers) because it is so encompassing it can incorporate the perspectives of many of our existing nursing theories and other psychological theories into a framework of the quadrants, identifying how each contributes to a panoramic whole.17 In addition, Integral Theory examines a “chain of pathologies” that causes illness rather than attempting to identify a singular cause. Holistic nurses understand the need for multiple modes of inquiry and multiple realities. Wilber’s theory provides a scholarly framework from which to embrace new understandings of nursing’s work. Clark has used the theory in her teaching and explains that this model has helped students to care deeply for patients and to experience nursing’s art as transformative.18 In using the integral model as a framework to view the complexities of the healthcare system in which we work, one observes that the current system is dominated by thinking in the physical and social domains and requires attention in the individual and collective internal domains. The integral model calls for a more comprehensive understanding of the health–illness, caring, healing, mind-emotion-body, and individual– cultural group relationships than are accounted for in daily practices. Because holistic nurses are at the forefront of much of the scholarship related to the internal domains, the integral model applied to nursing practice and published in the literature provides a call for translating nursing knowledge beyond the profession of nursing.19 See Chapter 8 for a description of the use of Wilber’s four quadrants as a way to understand the enactment of the holistic caring process. Other writings provide examples of
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